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红细胞分布宽度与经皮冠状动脉介入术后支架内再狭窄及预后的关系

Relationships between red blood cell distribution width and in-stent restenosis as well as prognosis after percutaneous coronary intervention

    摘要
  • 摘要:
      目的  探讨红细胞分布宽度（RDW）与冠心病患者经皮冠状动脉介入（PCI）术后支架内再狭窄（ISR）及预后的关系。
      方法  选取2017年9月—2021年7月在本院行冠状动脉造影确诊并行PCI治疗的280例患者，根据复查结果分为ISR组39例及非ISR组241例，统计主要终点事件发生率，分析RDW与冠心病患者PCI后ISR及预后的关系。
      结果   ISR组与非ISR组糖尿病史、吸烟史、RDW、串联支架、支架长度、支架直径的差异均有统计学意义（P < 0.05或P < 0.01）。多因素Logistic回归分析结果显示，糖尿病史、RDW、串联支架、支架长度、支架直径均为ISR发生的影响因素（P < 0.05）。随访结束时，280例患者中共44例（15.71%）发生终点事件。将280例患者分为RDW>13%组（n=102）和RDW≤13%组（n=178），2组预后主要终点事件比较，差异有统计学意义（P < 0.05）。生存分析显示，RDW>13%与RDW≤13%患者无终点事件生存率比较，差异有统计学意义（P < 0.05），且RDW>13%患者平均、中位生存时间均短于RDW≤13%患者。受试者工作特征（ROC）曲线分析显示，RDW对冠心病患者非致死性心肌梗死、心绞痛、心力衰竭及心源性死亡等预后结局均具有较好的预测价值（AUC=0.852、0.788、0.885、0.918，P < 0.05）。
      结论   RDW可作为冠心病患者PCI后ISR的影响因素，对患者预后具有较高的预测价值。

     

    Abstract:
      Objective  To investigate the relationships between red blood cell distribution width (RDW) and postoperative in-stent restenosis (ISR) as well as prognosis in coronary heart disease patients with percutaneous coronary intervention (PCI).
      Methods  A total of 280 patients diagnosed by coronary angiography and treated by PCI in authors' hospital from September 2017 to July 2021 were selected, and they were divided into ISR group (n=39) and non-ISR group (n=241) according to the review results. Incidence rate of primary endpoint events was counted, and the relationships between RDW and ISR as well as prognosis in patients with coronary heart disease after PCI were analyzed.
      Results  There were significant differences in the history of diabetes, history of smoking, RDW, serial stent, stent length and stent diameter between the ISR group and the non-ISR group (P < 0.05 or P < 0.01). Multivariate Logistic regression analysis showed that history of diabetes, RDW, serial stent, stent length and stent diameter were the influencing factors for occurrence of ISR (P < 0.05). At the end of follow-up, 44 cases (15.71%) had endpoint events in all the 280 patients. All the 280 patients were divided into RDW>13% group (n=102) and RDW≤13% group (n=178), and there was a significant difference in primary endpoint events of prognosis between two groups (P < 0.05). Survival analysis showed that there was a significant difference in endpoint-free survival rate between patients with RDW>13% and RDW≤13% (P < 0.05), and the mean and median survival time of patients with RDW>13% were significantly shorter than those with RDW ≤13%. The receiver operating characteristic (ROC) curve analysis showed that RDW had good predictive value for the prognosis of non-fatal myocardial infarction, angina pectoris, heart failure and cardiac death in patients with coronary heart disease (AUC=0.852, 0.788, 0.885, 0.918, P < 0.05).
      Conclusion  RDW can be used as an influencing factor of ISR after PCI in patients with coronary heart disease, and it has high predictive value for the prognosis of patients.

     

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